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Jul 07 06 09:47a Jeffrey C. Henley 714-739-1499 P.15 <br />RETROFIT OR REPAIR <br />1. Site map enclosed YES [-r' NO[] <br />2. Spec sheets attached for equipment to be installed YES[] NO <br />3. Description of work to be completed, <br />*Q 12 t2-4 <br />4. Description of equipment to be used: <br />i.A.bc-jtE - <br />5. All equipment is State certified or approved. YES NO j r,4 /A.- <br />6. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? N YES[] NO[] <br />b. Identify contractor performing decontamination: NA. /'C' <br />Name Phone( <br />Address city Zip <br />C. Describe method to be used for decontamination: <br />-- M <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />t—V 1P.— <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name f -.j a— Phone( <br />2 <br />